Doctor insights on:
Managing Infertility

1

Reproduction:
All the terms are related to reproduction, especially female reproduction. A reproductive endocrinologist (rei) is an obstetrician gynecologist that has had sub specialty training in infertility and female hormonal management.
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Infertility = inability to conceive or if a woman under age 35 - not being able to get pregnant after having regular sex for a year without birth control use. For a woman over 35 years old is not being able to get pregnant after having regular sex for 6 months.
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2

Inflammation:
Endometriosis is an inflammatory disease. Ivf avoids the problems with fertilization and egg transport, but there absolutely still could possibly still be issues with egg quality and with implantation.
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4

Yes:
Surgical approaches or radiological approaches to varicocele treatment should be equally effective. The differences come with cost and complications and recurrences. The recurrent rate of varicoceles is higher after embolization (10-20%) than with surgery (1-5%). For more info, see: http://www.Theturekclinic.Com/varicocele-treatment.Html.
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5

Uncertain if helps:
Acupuncture for fertility is not supported by great evidence. One study performed in seattle had lower pregnancy rates in acupuncture group doing ivf compared to no acupuncture group http://bbc.In/hq1my7. Hard to do controlled trials: what's the placebo (fake treatment) group - needles in 'wrong places' or needles that retract? (still get acupressure not acupuncture). Chinese herbs not recommended.
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8

Infertility:
The first step is to see a fertility specialist to go thru testing (both female and male). Depending on the findings, most issues can be successfully treated. Age is a big factor for women, so don't delay.
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13

Sometimes:
Pid impairs fertility usually through adhesion formation and tubal damage: laparoscopy can often be effective for treating adhesive problems involving the ovaries, but very much less succesful at treating tubes damaged by inflammation.
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14

May not be necessary:
Cysts of the pars plana area of the retina generally do not require treatment. Macular cysts and holes need to be evaluated and treated by a retinal surgeon. A victrectomy and tissue glue may be necessary. This can be major surgery. Cystoid macular edema is a swelling of the macula that may occur after trauma or surgery, especially cataract surgery. It is usually treated with meds or surgery.
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16

Trial and error:
there is no one "best" pill for ANY condition, although the pill manufacturers may try to make you believe there is. You need to work with a doctor who can go through the process with you. Good wishes.
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17

It is a choice?:
6 cycles of IUI on injectable medications costs around the same as one cycle of ivf. One takes 6+ months and ivf takes 6 weeks. Here is the "rub". 6 cycles of IUI is not as successful as 1 cycle of ivf. So it is a choice. By doing iui, you "gamble" that it works in 2-3 attempts and save money; but if not, than ultimately it costs more because when IUI does not work, you have to go to ivf.
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19

Don't lose hope...:
pregnancy only occurs in 20% of IUI cycles, have faith and keep on trying! Try speaking with your doctor or their nurse for encouragement if needed, infertility is tough mentally and most couples can use some extra emotional support!
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22

Vatican guidelines:
There is a specific policy of the catholic church - eggs from the wife and sperm from the husband should be fertilized within the body. Ivf, donor eggs and donor sperm use is not sanctioned. Iui is generally accepted as well as the gift procedure where fert occurs in the body. Not many centers still perform gift. Interpretations and adherence to this policy vary. Seek advice from your priest.
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28

Tough case:
Sorry to hear you have this condition. Since it is not correctable surgically you are really stuck with managing the symptoms. There are some interventional pain management techniques that may help. Spinal cord stimulation is an excellent option as an addition to medication management and psychological counseling for coping techniques.
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31

Infertility:
If you have been having sex for one year and not doing anything to prevent pregnancy, then you are considered infertile.
Some couples just take longer to get pregnant, it doesn't mean there is any problem.
If the woman is over 35, we recommend testing after 6 month, you don't have to wait a full year.
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32

Possibly:
Some forms of infertility are hereditary. For instance some forms of male infertility have genetic components that are automatically passed to male children (y chromosome microdeletions). Endometriosis definitely has a hereditary component. Pcos also runs in families. And fragile x which can affect egg production is hereditary as well. The vast majority of time infertility is not hereditary.
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34

Detect infertility:
You detect infertility when you have had intercourse but never pregnant. If this persists over time please see a gynecologist. You should go together with your significant other because the problem may be on his side not yours.
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